ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 986

Sex-Specific Associations Between Improvement in Gait Mechanics and Improvement in Pain, Function, and Abductor Strength after Total Hip Arthroplasty

J. Heather Brunner1 and Kharma C. Foucher2, 1Physical Therapy, University of Illinois at Chicago, Chicago, IL, 2Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: , , ,

Session Information

Date: Sunday, November 13, 2016

Title: ARHP I: Exemplary Abstracts

Session Type: ARHP Concurrent Abstract Session

Session Time: 2:30PM-4:00PM

Background/Purpose: There are sex disparities in both utilization and outcomes of total hip arthroplasty (THA).1 Identification of sex-specific biomechanical factors related to outcomes could lead to new perioperative rehabilitation strategies to ultimately reduce disparities. We have previously shown that gait mechanics are associated with self-reported function and pain.2 The purpose of this secondary analysis was to test the hypothesis that these associations differ by sex. We also hypothesized that associations between abductor strength and pain or function differ by sex.  

Methods: 124 subjects (age 61 ± 10; 64 Female; BMI 29 ± 5) from an IRB approved repository, were assessed before and ~1 year after THA. Dynamic sagittal plane hip range of motion (ROM) and peak 3D hip external moments, averaged from trials at subjects’ self-selected normal walking speeds, were analyzed. Hip abductor strength was assessed using manual muscle testing. Function and pain were assessed using Harris Hip Score (HHS) subscores. To test our hypotheses, we used first-order partial correlations to identify relationships between changes in HHS and changes in gait variables, controlling for speed. Next we used Pearson correlations to identify relationships between changes in HHS and muscle strength. Men and women were analyzed separately. We compared the associations by sex.  

Results: We found several sex-specific associations (Table 1). There were no associations between improved function and either gait or strength in men. By contrast, improved function was significantly correlated with increased hip ROM, peak adduction and external rotation moments, and abductor strength, in women. Improved pain was associated with increased ROM and decreased peak adduction moment, in men. Improved pain was associated with increased external rotation moment in women. There were no other associations (p > 0.112).  

Conclusion: Sex-specific associations among improvement in self-reported pain and function, and improvement in gait mechanics and strength, suggest that sex-specific rehabilitation may be helpful. Although these findings are preliminary, they may indicate that women could benefit from interventions to improve dynamic sagittal plane ROM, and frontal and transverse plane hip mechanics, as well as hip abductor strength. Further research should investigate the feasibility and effectiveness of sex-specific rehabilitation protocols.   References:

1.      Borkhoff CM, et al. Clin Orthop Relat Res. 2011;469(7):1829-37.

2.      Behery OA, Foucher KC. Clin Orthop Relat Res. 2014;472:3452-61.    

Table 1. Statistically significant associations between pre-to-post THA changes in self-reported outcomes and changes in hip mechanics and abductor strength.
Change in Dynamic Hip ROM Change in Peak Hip Adduction Moment Change in Peak Hip External Rotation Moment Change in Peak Hip Abductor Strength
Male Reported Change in HHS Function  Pain  Function Pain Function Pain Function Pain
R|speed = 0.202 R|speed = 0.284 R|speed =     -0.209 R|speed =      -0.261 R|speed = 0.146 R|speed = 0.128 R = 0.214 R = 0.068
p = 0.124 p = 0.029 p = 0.112 p = 0.046 p = 0.272 p = 0.333 p = 0.184 p = 0.675
Female Reported Change in HHS Function Pain Function Pain Function Pain Function Pain
R|speed = 0.474 R|speed = 0.119 R|speed = 0.437 R|speed = 0.189 R|speed = 0.360 R|speed = 0.336 R = 0.318 R = -0.030
p < 0.001 p = 0.354 p < 0.001 p = 0.138 p = 0.004 p = 0.007 p = 0.033 p = 0.846
Shading indicates a significant relationship between self-reported outcome and hip mechanic variable or abductor strength.
 
Disclosure: J. H. Brunner, None; K. C. Foucher, None.

To cite this abstract in AMA style:

Brunner JH, Foucher KC. Sex-Specific Associations Between Improvement in Gait Mechanics and Improvement in Pain, Function, and Abductor Strength after Total Hip Arthroplasty [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/sex-specific-associations-between-improvement-in-gait-mechanics-and-improvement-in-pain-function-and-abductor-strength-after-total-hip-arthroplasty/. Accessed .

« Back to 2016 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/sex-specific-associations-between-improvement-in-gait-mechanics-and-improvement-in-pain-function-and-abductor-strength-after-total-hip-arthroplasty/